8/31/2015. Introductions - MAPPING AN INNOVATIVE FUTURE. The Valley Hospital PIONEERING THE HEALING ORGANIZATION. Ridgewood, New Jersey

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1 - MAPPING AN INNOVATIVE FUTURE PIONEERING THE HEALING ORGANIZATION SESSION C708 OCTOBER 7, :30-12: ANCC NATIONAL MAGNET CONFERENCE Presented by: Ann Marie Leichman, MSN, RN, NEA-BC Beverly Karas-Irwin, DNP, RN, NP-C, HNB-BC, NEA-BC The Valley Hospital, Ridgewood, New Jersey Marie Shanahan, MA, BSN, RN, HN-BC Veda Andrus, EdD, MSN, RN, HN-BC The BirchTree Center for Healthcare Transformation, Florence, Massachusetts Introductions Veda Andrus, EdD, MSN, RN, HN-BC Vice President, Education and Program Development The BirchTree Center for Healthcare Transformation Marie Shanahan, MA, BSN, RN, HN-BC President / CEO The BirchTree Center for Healthcare Transformation Beverly Karas-Irwin, DNP, RN, NP-C, HNB-BC, NEA-BC Director of Professional Practice and Research The Valley Hospital Ann Marie Leichman, MSN, RN, NEA-BC CNO / Vice President, Patient Care Services The Valley Hospital The Valley Hospital Ridgewood, New Jersey 451 bed full service acute care hospital 2 nd busiest hospital in the state of New Jersey based on admissions Highly competitive marketplace with 7 acute care hospitals within 10 miles Third consecutive Magnet designation in

2 The Valley Hospital - The BirchTree Center A Collaborative Partnership The Valley Hospital 1998 new CNO - Linda Lewis, MSA, RN, NEA-BC, FACHE What I learned over the first 30 days in my role was that nursing, the heart of any hospital, was certainly in congestive heart failure as a result of apathy and distrust. We realized that we needed to do something quickly to re-engage the nursing professional for our long-term success. As the new CNO, this was a heartbreaking reality for me, and it immediately became my highest priority. p. 21. There was a genuine commitment to nursing, albeit a small flame. We had to co-create a model to ignite it once again. p. 22. Lewis, L. (April, 2009). Mission Critical: Building a Culture of Excellence. Nurse Leader, 7(2), The Valley Hospital - The BirchTree Center A Collaborative Partnership The environment at the time: Lack of compassionate caring presence High RN turnover Low patient satisfaction Quality of care issues Lack of participation in programs General lack of pride for professional nursing roles Re-ignite the soul of nursing The Valley Hospital - The BirchTree Center A Collaborative Partnership The BirchTree Center for Healthcare Transformation Nurse-owned holistic and integrative nursing education company: Florence, Massachusetts Focus: transforming organizational cultures - creating healing environments Presented at The Valley Hospital The (2001-present) Transformational Leadership for Innovative Organizations (2014) 2

3 Robert Wood Johnson Foundation New Jersey Health Initiatives Recruitment-Retention Grant (2003) A Return to Caring and Healing: Enriching the Professional Practice Environment for Registered Nurses Objective: To evaluate The on nurse retention, nurse peer group caring interactions, organizational climate for caring, and patient satisfaction Process: 2 in-patient units (N=36 54% and 36% saturation) Attend The one year 1 control unit did not attend program Measurements: Unit-specific turnover Patient satisfaction (Press-Ganey) Nursing job satisfaction (Nurse-Work Index) Perception of caring practices (Peer Group Caring Organizational Climate for Caring) Focus groups (actual experiences) Robert Wood Johnson Foundation New Jersey Health Initiatives Recruitment-Retention Grant (2003) A Return to Caring and Healing: Enriching the Professional Practice Environment for Registered Nurses Outcomes: Increase patient satisfaction 90 percentile both units end of study (Press-Ganey) Decrease RN turnover 5.71% and 16.13% - start of study 0% on both units - end of study Increase nursing satisfaction Increase RN caring perceptions The reduction in turnover alone more than offset the cost of implementation. Agency nurse usage which averaged $3-5 million in recent years fell to less than $150,000 and all patient outcomes measures, i.e., falls, medication errors, infection rates, are setting new record lows. Christianson, J., Finch, M., Findlay, B., Jonas, W., & Choate, C. (2007). Reinventing the Patient Experience: Strategies for Hospital Leaders. Chicago: Health Administration Press. Curriculum is based on the principles of holistic health, therapeutic presence, and person centered care members per cohort All areas of nursing represented 3

4 Nurses develop skills: self-awareness self-renewal /self-care presence intentionality stress management mindfulness resilience Use in the workplace and personally Reinforce the relationship between caring for self and increasing one s capacity for excellence in nursing practice Self-care is never a selfish act - it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Parker Palmer Let Your Life Speak: Listening for the Voice of Vocation, p.30. Game changers: Allow time for nurses to embrace self-care and holism as part of their professional role Leads them to model and teach their patients Needs support and rolemodeling from leadership to change the culture 4

5 Caring for self Transformational Leadership Effective holistic communication Philosophy of spirituality and healing Psychoneuroimmunology Mindfulness and resilience techniques Modern nutrition and supplementation Evidence based integrative modalities such as music therapy and aromatherapy 5

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8 National Board Certification in Holistic Nursing At the conclusion of the program: Nurses graduate with a certificate in Integrative and Holistic Nursing Prepared with the required experience, skills, and knowledge to sit for the national board certification in holistic nursing American Holistic Nurses Certification Corporation AHNCC.org administers the exam Meets the criteria for certifications listed in the Demographic Data Collection Tool (DDCT) by ANCC. Impact It has changed completely. I start my day with setting an intention; I take a few deep breaths before going to the unit to make sure that I bring a quiet and positive energy with me. I take my time when I do rounding to actively listen to my patient and take care of their needs as soon as possible. I have become a calmer nurse. I think I have a more positive attitude toward my unit and co-workers. My manger says that she has noticed a difference in my demeanor. Yes, I was heading into a burnout, but the only fire now is the one in my soul. It validated my personal belief of how our relationships with our colleagues, our patients and families should be. Presence first, task second. I m a more mindful and present person for myself and my patients. Thank you for allowing me to understand the importance of self care. Impact Culture change Knowledge transfer ~ Integrative Healing Council ~ New roles for nursing Practice changes - new knowledge and innovation ~ Project impact on nurse/unit ~ Tracking referrals 8

9 Impact Ownership Requested deepening leadership commitment to this model of practice Developed the confidence to lead this model at the unit level Articulation Increased personal and professional accountability for their contribution to creating a healing environment for patients and coworkers Valuing therapeutic presence and compassionate care Connection to caring science practice model and clinical excellence Building the Business Case Transformational Leadership for Innovative Organizations Timing was right Created the turning point ~ Leaders adopting Transformational Leadership concepts and behaviors Ah-ha moments Improved Emotional Intelligence Corresponded with their workload needs Correlated with current and ongoing organizational priorities Transformational Leadership for Innovative Organizations Holistic Practice became a significant presence in the organization Program outcomes enhanced interest/engagement Structural Empowerment ~ Supporting self-directed teams ~ Leaders and clinical caregivers now study and conduct projects together ~ All projects are chosen based on unit/team needs and are not leader driven Internal Audiences ~ Projects are presented internally at appropriate councils and forums 9

10 Structure NEW ROLES Integrative Healing Practitioner Holistic Birth Coordinator Structure Attendance National Board Certification in Holistic Nursing Structure Volunteer Nurse Program Integrative Healing Resource Nurses 10

11 Structure The Center for the Advancement of Integrative Healing Mission Course Offerings Foundations of Holistic Practice and Care Essential Oils for Clinical Practice Guided Imagery Structure Touch Therapy Energy Therapy Process Town Hall meetings Integrative Healing Council Bedside Harp Quiet Time Nursing Newsletter: Vital Capacity Renewal Room/Zen Den 11

12 Organizational Outcomes: Patient Satisfaction HCAHPS Questions Patients who reported that their nurses "Always" communicated well Patients who reported that their doctors "Always" communicated well Patient who gave their hospital a rating of 9 or 10 on a scale from 1 (lowest) to 10 (highest) Patients who reported YES they would definitely recommend the hospital The Valley New Jersey Hospital Average National Average 85% 76% 79% 85% 78% 82% 80% 64% 71% 83% 67% 71% The Valley Hospital HCAHPS scores for calendar year Publically reported HCAHPS scores lag by one year. Organizational Outcomes: Dissemination of Work to External Audiences Publications: 4 Interviews: 9 Podium Presentations: 9 Poster Presentations: 7 12

13 Nursing Research The Effect of the Essential Oil Ginger (Zingiber officinale) on Post-operative Nausea and Vomiting The Use of the M Technique in the NICU Nursing Research The Effect of a Drumming Circle on Perceived Anxiety in Drumming-naïve Adults Most Recent Accomplishment 13

14 Care Advocacy Respect Excellence THE ART OF NURSING References Assi, M., & Shanahan, M. (2005). Holistic care & nursing science: retaining magnet excellence. Excellence In Nursing Knowledge. Bien, T. (2006). Mindful Therapy: A guide for therapists and helping professionals. Somerville, MA: Wisdom Publications Inc. Bischoff, M., & Buckle, J. (2014). The M Technique for Pregnancy, Labor and Post-partum. International Journal Of Childbirth Education, 29(4), Brenner, H. (2013). The Center for Holistic Birth: An Organized Step Back in Time When Birthing Worked. JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing, 42S24-5. doi: / Christianson, J., Finch, M., Findlay, B., Jonas, W., & Choate, C. (2007). Reinventing the patient experience: Strategies for hospital leaders. Chicago: Health Administration Press. Feldman, V., & Sobrino-Bonilla, Y. (2014). Dim Down the Lights: Implementing Quiet Time in the Coronary Care Unit. Critical Care Nurse, 34(6), doi: /ccn Hamill, J., & Mazzer, M. (Jan/Feb, 2014). Holistic healthcare: Not yet mainstream, but quickly rippling across communities. My Whole Person, 8-9. Lewis, L. (April, 2009). Mission critical: Building a culture of excellence. Nurse Leader, 7(2), McGovern, B. A., Brenner, H. Z., & Brindisi, S. V. (2012). Local beat. Nurse.Com Nursing Spectrum (New York/New Jersey Metro), 24(19), 2. Palmer, P. (2000). Let Your Life Speak: Listening for the Voice of Vocation. San Francisco: Jossey- Bass. Contact Information Veda Andrus EdD, MSN, RN, HN-BC vandrus@birchtreecenter.com Marie Shanahan, MA, BSN, RN, HN-BC mshanahan@birchtreecenter.com Beverly Karas-Irwin DNP, RN, NP-C, HNB-BC, NEA-BC karabe@valleyhealth.com Ann Marie Leichman MSN, RN, NEA-BC aleichm@valleyhealth.com 14